Vestibular migraine or Meniere's disease: a diagnostic dilemma.
Vestibular migraine or Meniere's disease: a diagnostic dilemma.
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前庭偏头痛或梅尼埃病：诊断困境
DOI：
10.1007/s00415-022-11532-x
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发表时间：
2023-04
影响因子：
6
通讯作者：
Zhang, Su-Lin
中科院分区：
文献类型：
--
作者：
Chen, Jing-Yu;Guo, Zhao-Qi;Wang, Jun;Liu, Dan;Tian, E.;Guo, Jia-Qi;Kong, Wei-Jia;Zhang, Su-Lin
梅尼埃病（MD）是一种以三联征（反复性眩晕、波动性听力损失、耳鸣或耳闷胀感）为特征的眩晕性疾病。 MD的诊断依赖于准确、详细的病史采集，从治疗效果的角度来看，MD与前庭性偏头痛（VM）的鉴别至关重要。 VM 是一种非常普遍的眩晕病症，其典型症状（头痛、前庭症状、耳蜗症状）与 MD 相似。此外，MD和VM的误诊可能导致VM患者错误地接受针对MD设计的创伤性治疗方案，并对内耳造成不必要的损伤。幸运的是，由于检查技术的进步，它们区分的障碍正在逐渐消除。这些进步提高了眩晕疾病的诊断准确性，尤其是 VM 和 MD。本综述重点关注VM和MD的鉴别，试图综合鉴别诊断相关组（涵盖核心症状、辅助测试[听力测试、前庭测试、内淋巴积水测试]）和纵向随访的现有数据。由于这两种疾病在各个方面都有重叠，因此没有任何一项测试本身就足够具体，但是，包含所有或至少某些特征的模式可以提高特异性。
Meniere’s disease (MD) represents one of the vertigo disorders characterized by triad symptoms (recurrent vertigo, fluctuating hearing loss, tinnitus or ear fullness). The diagnosis of MD relies on the accurate and detailed taking of medical history, and the differentiation between MD and vestibular migraine (VM) is of critical importance from the perspective of the treatment efficacy. VM is a highly prevalent vertigo condition and its typical symptoms (headache, vestibular symptoms, cochlear symptoms) mimic those of MD. Furthermore, the misdiagnosis in MD and VM could lead to VM patients mistakenly receiving the traumatic treatment protocol designed for MD, and sustaining unnecessary damage to the inner ear. Fortunately, thanks to the advances in examination technologies, the barriers to their differentiation are being gradually removed. These advances enhance the diagnostic accuracy of vertigo diseases, especially VM and MD. This review focused on the differentiation of VM and MD, with an attempt to synthesize existing data on the relevant battery of differentiation diagnosis (covering core symptoms, auxiliary tests [audiometry, vestibular tests, endolymphatic hydrops tests]) and longitudinal follow-up. Since the two illnesses are overlapped in all aspects, no single test is sufficiently specific on its own, however, patterns containing all or at least some features boost specificity.
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